Liposuction or lipoaspiration is a cosmetic surgery technique that has been in use for about twenty years and which is rapidly becoming the most widely practiced cosmetic surgery procedure in the world.
It consists of using suction to eliminate localized deposits of excessive subcutaneous fat in certain areas of the body, for example, the chest, the buttocks, the hips, or the thighs.
The conventional apparatus for this type of intervention comprises a hollow cylindrical cannula with one or more orifices near its distal extremity. This cannula is connected at the other end to a suction source, generally a vacuum pump, for the purpose of suctioning fat cells through the orifices and then evacuating them through the hollow interior portion of the cannula. A receptacle for recovering the suctioned fat is placed between the cannula and the suction source.
During the intervention, the surgeon first uses a syringe to inject a tumescent solution into several locations in the fatty area to be treated. This solution—generally a mixture of anesthetic products, vasoconstrictors and disaggregators with physiological serum—softens the fatty tissue and facilitates the process of dislocating it using evacuation.
After having waited long enough for the tumescent solution to infiltrate and act, the surgeon makes one or more incisions in the patient's skin at appropriate locations over the area to be treated to serve as points of entry for the cannula extremity.
The surgeon introduces the cannula below the skin through one of these incisions and suctions the fat by repeatedly moving the cannula back and forth longitudinally in the fatty area to be treated. Thus, the subcutaneous fat is mechanically dislocated by the movement of the cannula and then evacuated using suction.
After having removed all the adipose material accessible from this orifice by changing the direction of cannula action, the surgeon removes the cannula and reintroduces the cannula through another point of entry. He or she repeats the preceding operation using a crossing technique, also called tunneling.
When it becomes too difficult to move the cannula through the fatty tissue, further tumescent solution is reapplied. This injection must be followed by a waiting period in order for the solution to infiltrate properly, prolonging the time required for the surgery.
The surgeon proceeds in this way until enough fat has been removed to correct the areas the patient is dissatisfied with.
While this technique is generally satisfactory because of its simplicity and effectiveness, it requires considerable physical effort on the part of the surgeon to move the cannula back and forth. The intervention is very physically taxing for the surgeon who, despite the high demand, cannot perform multiple operations in one day.
Furthermore, during the procedure the surgeon may become so tired from the effort expended that he moves in a random, uncontrolled or even rough fashion, so the fat is not removed homogeneously. This causes the appearance of esthetically objectionable “waves” or rolls of fat at the surface of the treated area.
In addition, another difficulty encountered during a liposuction intervention is that the fat cells are sometimes difficult to detach from surrounding tissue, often forming clumps or nodules that block the cannula.
In this case the cannula must be removed, unblocked and reintroduced, thereby prolonging the intervention needlessly and causing additional trauma.
Another solution consists of intensifying suction in order to eliminate the fat plug. However, this requires very strong pressure, which can coincidentally harm surrounding tissue.
One current approach to eliminating the risk of plugging consists of using a larger diameter cannula. Obviously, this inflicts more trauma on the patient due to introduction of a larger cannula and causes significant scarring, requiring more time for reabsorption.
The result is an intervention that is challenging for the surgeon, needlessly long and often painful for the patient, in which it is impossible to completely control fatty tissue extraction, often resulting in an irregular, unesthetic epidermal surface over the treated area.